Symptoms

One of the first steps in understanding hidradenitis suppurativa is educating yourself about the signs and symptoms of the condition. Here, you can learn about the variations of HS and view photos of patients living with HS.

Hurley stage III

Because hidradenitis suppurativa may be mistaken for an infection, a long delay to get a diagnosis is common.1,2 Painful abscesses formed due to HS either go away on their own, or rupture discharging pus. It’s common for the affected areas to emit an unpleasant odor.3

Dermatologists typically assess HS clinically, considering multiple factors that include lesion appearance, lesion location and chronicity (ie two or more recurrences in six months). Different assessment scales may also be used, including the Hurley lesion classification, HS-PGA severity scale and pain scales.1

Hurley grade I lesions: Single or a few isolated boils without sinus tracts or scarring1,2

Painful bumps and abscesses in the armpits, groin, under the breasts, buttocks or inner thigh. These tender bumps generally start as firm, pea-sized nodules. Since they typically are red, the nodules are often mistaken for acne, an ingrown hair or sexual disease such as herpes.3

Scarring can occurs with HS as a result of long-term or repeat occurrences in a single location.3

Hurley grade III lesions: Widespread boils (some as large as golf balls) with multiple interconnected sinus tracts, which may lead to severe scarring and release of unpleasant-smelling pus.1,2,3,4

Not all cases of hidradenitis suppurativa are progressive (meaning that the condition can increase in severity over time). However, some cases of HS can continue to reappear and grow more severe over time. As a result, diagnosing and properly managing HS as early as possible is critical.2,4 The first step for HS patients is to speak to your dermatologist to help ensure an accurate diagnosis.

It’s important for those living with HS to have an open and honest dialogue with your physician. Because HS is not a widely known inflammatory skin disease, it is recommended that you consult a dermatologist (who specializes in skin health) with any questions you have. Visit our Talking to Your Dermatologist section for information and tips to help guide a discussion with a dermatologist or to prepare for a discussion to get a referral to dermatology from another physician.

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